J-shaped association between dietary zinc intake and new-onset hypertension: a nationwide cohort study in China / 医学前沿

We aimed to investigate the relationship of dietary zinc intake with new-onset hypertension among Chinese adults. A total of 12,177 participants who were free of hypertension at baseline from the China Health and Nutrition Survey were included. Dietary intake was assessed by three consecutive 24-h dietary recalls combined with a household food inventory. Participants with systolic blood pressure ≽ 140 mmHg or diastolic blood pressure ≽ 90 mmHg or diagnosed by a physician or under antihypertensive treatment during the follow-up were defined as having new-onset hypertension. During a median follow-up duration of 6.1 years, 4269 participants developed new-onset hypertension. Overall, the association between dietary zinc intake and new-onset hypertension followed a J-shape (P for non-linearity < 0.001). The risk of new-onset hypertension significantly decreased with the increment of dietary zinc intake (per mg/day: hazard ratio (HR) 0.93; 95% confidence interval (CI) 0.88-0.98) in participants with zinc intake < 10.9 mg/day, and increased with the increment of zinc intake (per mg/day: HR 1.14; 95% CI 1.11-1.16) in participants with zinc intake ≽ 10.9 mg/day. In conclusion, there was a J-shaped association between dietary zinc intake and new-onset hypertension in general Chinese adults, with an inflection point at about 10.9 mg/day.

Impact of and risk factors for pediatric acute kidney injury defined by the pROCK criteria in a Chinese PICU population.

BACKGROUND: The definition of pediatric AKI continues to evolve. We aimed to find a better AKI definition to predict outcomes and identify risk factors for AKI in a Chinese PICU. METHODS: This study consisted of 3338 patients hospitalized in a Chinese PICU between 2016 and 2018. AKI was defined and staged using pROCK criteria, which were compared with KDIGO criteria. AKI outcomes, including mortality, daily cost and length of stay (LOS), were assessed. Risk factors for AKI were also estimated. RESULTS: The incidence of AKI in the PICU was 7.7% according to pROCK criteria. The characteristics of patients with KDIGO-defined AKI who did not meet the pROCK were similar to those without AKI. pROCK outperformed KDIGO in predicting mortality with a higher c index in the Cox models (0.81 versus 0.79, P = 0.013). AKI, as well as AKI stages, were associated with higher mortality (HR: 10.5, 95%CI: 6.66-19.5), daily cost (ß = 2064, P < 0.01) and LOS (ß = 2.30, P < 0.01). Age, comorbidities, mechanical ventilation (MV), pediatric critical illness score (PCIS) and exposure to drugs had significant influence on AKI occurrence. CONCLUSIONS: The mortality predictability of pROCK was slightly greater than that of KDIGO. Older age, underlying comorbidities, MV, decreased PCIS and exposure to drugs were potential risk factors for AKI. IMPACT: Two AKI criteria, pROCK and KDIGO, were significantly associated with an increased risk of mortality and pROCK was slightly greater than that of KDIGO. Older age, comorbidities, mechanical ventilation, decreased PCIS and exposure to drugs were potential risk factors for AKI. This study first used the pROCK criteria to provide an epidemiologic description of pediatric AKI in Chinese PICU. This study compared the AKI outcomes across the pROCK and KDIGO AKI criteria, indicating the prior utility for AKI classification in Chinese children. This study indicated that the potential risk factors for AKI were older age, comorbidities, mechanical ventilation, decreased PCIS and exposure to drugs.

The association between smoking status and carotid artery plaque in rural areas of Eastern part of China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the correlation between smoking status and carotid plaque in rural population residing in Eastern part of China.</p><p><b>METHODS</b>Between July and September of 2013, an epidemiological survey was carried out in residents aged 40 or above men who were enrolled randomly in rural areas of Anqing, Anhui province and Lianyungang, Jiangsu province. The data on epidemiological characteristics including smoking status, physical examination were collected using standardized protocol, and carotid ultrasonography was applied to examine the incidence of carotid plaque among never smokers, former smokers and current smokers. Logistic regress analysis was performed to determine the effect of smoking on carotid plaque.</p><p><b>RESULTS</b>In the study, a total of 625 male participants were included in the study. 51.4% (321 cases) were current smokers, 21.3% (133 cases) were former smokers, and 27.4% (171 cases) were never smokers. 32.0% (200/625) had carotid plaque. The incidence of carotid plaques was significantly higher in current smokers (35.2%, 113/321) than that in never smokers(23.4%,40/171) (χ(2) = 7.26, P = 0.007) and the incidence in former smokers (35.3%, 47/133) was also higher than that in never smokers (23.4%, 40/171) (χ(2) = 5.23, P = 0.022). Multiple logistic regression analysis showed that current cigarette smoking is significantly associated with the increased risk of carotid plaque (OR = 1.84, 95% CI: 1.13-2.98, P = 0.014) in comparison with never smokers, and there was an interaction between current smoking and age in association with carotid plaque. Compared with the young (≤60 years old) and never smoking group (8%, 3/40), prevalence of carotid plaque among the elderly (>70 years old) and smoking group (55%, 31/56) was significantly higher (OR = 8.06, 95% CI: 2.07-31.45) after adjusting for age, systolic blood pressure, diastolic blood pressure, blood glucose, total cholesterol, triglyceride high-density lipoprotein, body mass index, drinking and regional differences.</p><p><b>CONCLUSION</b>It found that cigarette smoking was associated with increased risk of carotid plaque in rural elderly population residing in Eastern part of China.</p>